Source: The Conversation (Au and NZ) – By Hazel Dalton, Senior Research Fellow, Rural Health Research Institute, Charles Sturt University
According to the latest polling, the right-wing populist party, One Nation, is gaining significant political ground.
But the party has also made headlines for its controversial proposal to make new doctors complete a period of regional or rural service, in return for getting a Medicare provider number. This number is essential for accessing Medicare services such as bulk billing, where patients pay no out-of-pocket expenses for seeing a GP.
One Nation’s proposal is a blunt solution to a real problem. But could this policy actually work?
What exactly is One Nation proposing?
Earlier this week, One Nation MP Barnaby Joyce raised the idea of requiring doctors to work regionally before they can work in cities. If they don’t do a regional stint, they would essentially be blocked from practising under Medicare, Australia’s national health insurance scheme.
As a result, they would not have the option to bulk-bill or refer patients for pathology tests, such as biopsies and blood tests. This means patients can’t get rebates for seeing a doctor. For a ten-minute consultation which costs about $90, for example, the patient would not get the $43.90 rebate back.At this stage, the proposal is short on detail. It’s unclear if it will apply to all medical graduates, and how long they will required to stay in a rural or regional location. But Joyce has suggested the length of service vary by remoteness. This would mean doctors who work in more remote locations would serve shorter terms.
So, could this policy work in practice?
Probably not. Australia has both a shortage of GPs and an unevenly distributed GP workforce. And a compulsory rural service policy does little to address either problem.
While the number of GPs in Australia has grown, particularly between 2018 and 2023, this growth has not kept pace with the demand for doctors. And the gap is even wider in rural areas.
A compulsory period of service might increase the number of newly qualified GPs in some rural communities. But research suggests they won’t stay long. Many forced service programs struggle to retain people after the service period ends. And even if existing doctors leave and are replaced by new ones forced to work in the country, this is a problem because local patients can’t benefit from continuity of care.
One American study tracked 240 international medical graduates who, because of their visa requirements, had to work rurally for three years. It found most relocated to urban areas within two years of fulfilling that visa requirement.
If you look at the distribution of our GP workforce, there is a clear pattern: GP numbers drop as remoteness increases. As a result, small rural towns have the fewest GPs relative to their population.
This matters because these communities are often too small to sustain a private general practice. And they are usually too far from larger regional centres for residents to easily access care.
Unfortunately, these are structural problems a coercive rural service policy are unlikely to fix. Instead, we should focus on programs which reward doctors for working in the regions.
One example is the Workforce Incentive Program (Doctor Stream). This program offers medical graduates an annual payment which increases according their year of service and level of remoteness.
Funding is also available for rural doctors seeking professional development. These include the Rural Procedural Grants Program and the Australian General Practice Program. As of 2026, the Australian General Practice Program has an additional 100 places dedicated to training rural GPs.
Are there any downsides to this policy?
Yes. Here are three.
First, this policy devalues regional communities. If we force doctors to go to rural communities, it reinforces the idea that rural places aren’t worth choosing. Medical schools already tend to frame metropolitan practice as the goal, and rural practice as the back-up plan. Forcing graduates into rural service may deepen that stigma. So instead of strengthening rural health care, this policy would discourage the long-term commitment rural communities actually need.
Second, it may increase medical costs for rural patients. Based on Joyce’s comments to date, doctors without a Medicare Provider Number will not be allowed to bulk-bill. This means they will charge fees, shifting the cost of health care to patients.
Third, this policy might discourage people from pursuing general practice altogether. Australia is already facing a GP shortage, which is only expected to get worse. For young medical students, a period of compulsory service scheme might become another barrier to pursuing a career in general practice.
One Nation’s proposal may sound straightforward. But without considering the details and potential risks, it may just exacerbate our current shortage of rural and regional GPs. So to find a solution, we may have to go back to the drawing board.
– ref. One Nation wants to get more doctors in rural areas – but it’s got the wrong approach – https://theconversation.com/one-nation-wants-to-get-more-doctors-in-rural-areas-but-its-got-the-wrong-approach-276753
